Question for Professionals
For professional’s, In a situation where you’re working with a patient, particularly a younger client (child), and they are getting upset/fed-up with a particular exercise or practice. What are some strategies that allow you to pause and reassess the child, or establish a safe space?
Hello RobS,
Thank you for your question!
In case of younger children, I have always found enquiry into the “how” and the “why” to be more useful rather than the “what”. I know that sounds very vague, so let me explain.
WHATever technique you deem fit for the child based on evidence and the child’s needs, HOW you introduce it to the child is of primary importance. Even an exercise that we might feel is repetitive or monotonous, when introduced in multiple fun ways, involving different combinations of people, and different modes of reinforcement, can be very well accepted by the child.
The second question, WHY, is equally important. Why is this child needing to continue the same exercise at the same level? Is it because the parent is not conducting it the way we demonstrated it to them? Ask the parent to carry out the exercise/ activity in the clinic every once in a while to rule out this reason. Is it because the choice of technique is not suitable to this child? Is a combination of approaches more appropriate? Having detailed session records and going over them usually helps solve this problem. Finally, is any extraneous variable (within the parent-child dyad or beyond) acting as a barrier to the child moving forward in therapy?
These are some of the ways and means of moving out of your phase of impasse in therapy. It helps to evaluate your progress every 5-6 sessions to troubleshoot for problems if any, before the child even shows signs of being fed up. However, if such an instance does occur in the session, following the child’s lead for an activity of choice and moulding the activity to suit your goal, usually helps.
You must also be cognisant of the possiblity that a child who ‘seems’ to be fed up of the activity might actually be acting out because of something else that they want to communicate to you. Switching over to non-directive play for some part of the session might help, in that case, to get to the root cause of the child’s unhappiness. In addition, reiterating to parents the importance of keeping communication channels open at home is extremely important as well. Relaxed time spent chatting with the parent is when the child might choose to come out with what’s bothering them.
So lot’s of things that can be done, but the bottomline is to be patient, calm and receptive, and find the source of the problem. Hope that helps!
Pallavi