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Collaboration and Strong Therapeutic Relationships in Child Psychotherapy

Senior Intake Coordinator, Melanie DelAngelo, sat down with CFI clinician, Jason Lewinter, LMSW, to understand the importance of building strong therapeutic relationships with child clients, as well as working collaboratively with parents and external providers in a child’s life.

Melanie: Why is a strong therapeutic relationship between a clinician and client important, and how do you build such a relationship with child clients?

Jason: A strong therapeutic relationship is important because it lays the foundation for all of the work you hope to accomplish with a client. 

To build a strong relationship with a child client, the most important thing is to make sure the child understands that the roles in this [therapeutic] relationship are slightly different from what they traditionally expect when working with an adult. I want the child to understand that I work for them, and they aren’t here to meet my needs. I am not their teacher, their boss, or someone who is going to tell them to do something and then be upset if they do not follow through. To convey this message, I set up sessions, especially in the beginning, in a way that follows the child’s lead in where they want to go. Oftentimes, children have an inclination as to why they are speaking to a therapist. It’s important not to force that conversation too early, however, and find ways to learn about the child that isn’t hyper-focused on why they are meeting with me. 

I seek to empower my clients to take an active role in their treatment: to come to their own realizations and make their own decisions. I want my clients to feel genuinely respected and cared for in a way that is not critical of them, and so they can see themselves as more than a behavior, more than a condition, etc. To do this, I work collaboratively with them to set goals that align with their values and cultural beliefs, and then incorporate relevant cultural aspects and values into our sessions. Recognizing, and furthermore incorporating, a client’s culture and values helps them to feel understood, respected, and more likely to open up and engage in the therapeutic process. 

It’s important to note the role of self-awareness here, as well: acknowledging my own limitations and biases, ensuring I am using inclusive language, and actively seeking to learn from each of my client’s unique perspectives. For example, if a client tells me about a family, religious-based tradition that I am unfamiliar with, asking questions and opening a space to talk about what that tradition entails and what it means to the child not only helps me learn, but also strengthens our therapeutic relationship. 

Melanie: What does it mean to work collaboratively with parents and other providers in a child’s life? What are the implications, therapeutically, of collaboration with parents, schools, and outside providers?

Jason: Whether it’s school personnel, a psychiatrist, parents, whomever, each type of person sees a child through a certain lens with certain expectations. It can be helpful to collaborate with parents and other providers to broaden that lens and/or give a different perspective on who the child is, enabling them to see the child as a whole person, rather than as a specific behavior or obstacle. Collaboration also allows for the development of different perspectives on what is creating obstacles for the child, and what can be helpful to the child in overcoming those obstacles. 

Melanie: Do you have any final tips for parents to take away after reading this piece?

Jason: To any parents and children who are beginning a relationship with a new therapist, I recommend that parents have a conversation with the therapist about what the therapist’s style of communication might be with them. This can occur during a consultation call or at the initial intake appointment. Every therapist has a different style of communication, and every parent has different expectations about the type and frequency of communication to be had with their child’s therapist. Open dialogue is important, and parents should feel like they can engage in pretty direct questioning on the therapist’s style, experience, etc. to assist them in determining whether or not the therapist will be the right match for their child and family. 

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