When working with children I have drawn upon a sequentially planned integrative counselling model. This model follows a child’s spiral of therapeutic change and I facilitate this process using the methods outlined below. When establishing Best Start Therapy I wanted to bring something new when working with Children and Young people rather that working from a fixed theoretical orientation such as a Cognitive Behavioural Therapy (CBT), or a Person Centred approach. I have elected to work from an Integrative Methodology which means I use a range of theoretical orientations such a Gestalt, person centred, CBT, narrative, psychodynamic, and transactional analysis to name but a few. Alongside these methods I draw upon the latest research in neuroscience and attachment theories to contribute to my practice. I feel this gives me greater freedom to meet the children and young people’s needs, and work in a more integrative way.
Alongside this theoretical approach I work creatively using a range of what is called “creative media” such as paint, puppets, building materials such as Lego© and games, I have even been known to play pool / snooker with older children when its available. I find this helps the children and young people convey their thoughts and feelings in a way that is safe for them without having to just sit and talk, which some adults can find intimidating. Sometimes we find it hard to find the words that truly express how we feel, sometimes children and young people do not have the language skills to put their feelings into words or the experience to bring this to a session, using creative media offers an alternative to words and opens up the therapeutic process.
Generally when commencing therapeutic work with an individual the process begins with a referral, usually from a member of the Senior leadership team in a school ,or case manager else where. I read through the referral, and corresponding paper work, such as reports from appropriate services, to gain a history and background. From there I decide whether it is an appropriate case for me to take on, if it is not I normally work with the referrer to make an appropriate referral to another agency such as CAMHS.
Once I have accepted the referral, I make contact with the parents/carers and introduce myself and then I like to conduct an intake session where I get the parents’/carers’ perspective on the reason for the referral and what their expectations are from the service. I also collect all relevant family history as far back as pregnancy as this will help in my case formulation. Once I have this I obtain parental consent, I then introduce myself to the young person and explain what I have undertaken so far in an age appropriate manner and ask if they would like to continue in this process. It is important that the child/young person wants to engage and whilst I recognise that the therapeutic process can be hard and children may resist the process at certain stages, if they want to engage initially it helps later if they do start to disengage.
From here I normally contract to a six session assessment with the young person, school and parents/carers as this gives me time and space to build the relationship and allows the young person to tell their story. As the young person tells their story it brings together the pre intake reading and intake session with parents/carers and allows me to create a clinical case formulation that is appropriate to the young person’s needs.
At the end of six sessions the young person and I have a review session where we discuss how the six sessions have gone, at this point I would share the treatment plan I have created and see if these goals for therapy are appropriate. If the young person and I are in agreement then I will have a review with the school/case managers and parents/carers to share the appropriate case formulation and the goals for therapy. From then on the reviews are set as appropriate in relation to the defined goals of therapy. Working in an educational setting I find half terms and end of terms are good points in which to review as it creates a natural break or pause in the therapeutic process, however reviews can take place at any time if it is appropriate.
At the start of therapeutic process I ask teachers, parents/carers, and the young person to complete an SDQ form to establish a base score. I then repeat this process at appropriate points in the therapeutic process to gain data, however this is some times not always conclusive evidence on the progression of therapy and is only used as an aid.
When the goals of therapy have been achieved, or I feel I have gone as far as I can in the young person’s process, I will then conduct a review with all stakeholders and either close the case, or refer onto the next appropriate agency.
Once the case has being closed I will produce a report on the goals of therapy and how they have being achieved or not depending on the case, this will be shared with the young person and agreed upon before sharing with appropriate people.
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