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A Closer Look at Child Psychotherapy


What is Child Psychotherapy?
Child psychotherapy is a psychodynamically based assessment and treatment approach that works with children and adolescents who experience difficulties in their emotional, social and behavioural development.  A child psychotherapeutic focus is on children’s inner feelings and understandings and how they see and experience their environment. Through careful observation and direct respectful dialogue with the child, patterns that are interfering with healthy development are identified. The underlying meanings of these patterns of behaviour are sought and clarified.

The work of child psychotherapy occurs within the context of the family and the wider environment.

The aim of child psychotherapy is to develop the child’s capacity for growth and development by establishing more appropriate ways of coping within their environment.


Child psychotherapists
Child psychotherapists are a group of people who have psychodynamically based training, knowledge and skills in working with children and families who are experiencing difficulties in everyday life.

Child psychotherapists use a variety of approaches in working with whole families, groups or individuals of any age.


Who do child psychotherapists work with?
Child psychotherapists work with emotionally disturbed children, adolescents and their families. They deal with psychological health problems such as:

• developmental delay due to social and emotional factors • the effects of physical differences
• effects of physical, sexual and emotional abuse • child-parent problems
• attachment problems • mental health problems
• problems of aggression and violence • family dysfunction
• childhood depression • emotional/social skill deficits
• suicide threats and attempts • environmental pressures
• withdrawal and neurosis • self image
• psychosis • identity
• children with chronic illness and dying children • aspects of spirituality
• enuresis and encopresis • adjustment problems
• effects of trauma • effects of loss and grief

How do child psychotherapists work?
Child psychotherapy offers children a safe and trusting environment within which they are able to explore strong feelings such as fear, sadness, hurt, anger, anxiety or confusion about themselves, their family or other aspects of their lives.  

Children use play as well as language to communicate heir thoughts and feelings so as to enable understanding and growth. The therapeutic work takes place in a space well equipped for this purpose. In order to facilitate this experience the therapist, the room and its contents remain consistent. In work with adolescents where language plays a larger part in communication, the environment is structured towards this difference.

Psychotherapeutic work with parents is aimed at supporting their developing understandings of family and child interactions and the need for change.


Where can child psychotherapists work?
Child psychotherapists are equipped to work in a variety of settings including public health facilities, private practice, community services, school settings and the social welfare and justice systems. Child psychotherapists work for District Health Boards (Child and Adolescent Mental Health Services) and Child, Youth and Family Services (CYFS), they also help clients referred through doctors, social workers and the courts. Others may be found in Church Social Services, and some work in private practice on a fee-charging basis.

A child psychotherapist may work with:
• a child or adolescent individually
• with children and adolescents in group therapy
• with the parents
• with the family
• with school and other community agencies to assist them to understand more clearly the needs, feelings and conflicts within children

They are also able to provide a consultative resource to the large number of primary care workers, both paid and voluntary, working therapeutically with children in various community settings.


Individual work
In individual work a secure, trusting relationship is established where confidences are respected. In this situation young people can gain understanding of their feelings and relationships and work towards personal change.  

Whereas adults find relief in talking over problems, children often cannot express their thoughts and feelings in words, so play and art forms are used.

As children become secure in the use of the playroom through their special relationship with the therapist, they gradually share their good and bad feelings through play, and come to understand their difficulties.


Family work
In family work families are helped to understand their difficulties so that they can make the changes which they see as important and possible for them.


Some other areas of work
Child psychotherapists also:

• provide supervision to other professionals working therapeutically with children.

• help community groups
• liase with doctors, teachers, and other professionals
• teach parents about normal emotional development
• assist the family courts
• run or oversee groups for adolescents and children with special needs
• run or oversee parent support groups.


Examples of common difficulties
• Nine year old Peter witnessed domestic violence for some years when he was a toddler: currently, he appears to be having an anger problem. His parents wonder if this is a link.

• Thirteen year old Natalie has had a heart operation when she was eight months old. She always has had dreams about being attacked and getting hurt: She would like those dreams to stop.

• Eight year old Paul's twin brother was killed in a car accident three years ago. He has since developed significant changes in his personality, appears anxious and refuses to talk about his loss. How can he be helped to deal with his loss.

• Five year old Ross had serious eczema that alienates him from his peers, has caused his self-esteem to suffer and there is by now a pattern of self deprivation. His parents feel his mood is down and would like some help for him.

• Gillian and Tom have formed a reconstituted family with a total of six children. One five year old boy is scapegoated by the oldest two boys. Both parents feel frustration, rivalry and defensiveness playing up in their parenting of the children and sense that they need assistance to avoid another family break-up.


What you should expect
You should expect child psychotherapists working in New Zealand to have either a Graduate or Post Graduate qualification in Child Psychotherapy or a Masters in Health Science or to possess an equivalent overseas qualification AND registered with the Psychotherapists Board of Aotearoa NZ.  



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