Therapy for Kids

I used to work in childcare, and I was often brought in to work with “special needs” kids because those kids were often drawn to me. I came to realize how these kids often played out their fears and concerns, and learned how to do a few things: Help demystify kids’ behavior problems, and play and talk with kids in ways that made sense to them. In the midst of all that, I came to be known as someone that could talk with parents and teachers about the “difficult” kids, someone who could often identify what was happening with a kid, and what she needed most.

I love that work. A few stories really stand out to me:

I was once asked to work with a second grade girl who I was told “doesn’t speak at all”. The implication was that she was emotionally disturbed. When I hear something like that, I keep my eyes and my ears open and work with different avenues of communication. Within moments of meeting this girl, she was giggling as we made funny faces at each other. She didn’t speak, but she didn’t seem disengaged at all. I got out some drawing paper, and we were soon having fun drawing together. The most fun came when I turned on some music, and we danced. When her father came in to pick her up at the end of the day, I chatted with him about how delightful his daughter was. I mentioned that we had lots of fun playing, and that she didn’t talk. Any idea he might have about that? It turned out they had lived in China for several years and had just moved to the states. She didn’t know English! The teacher who brought me in to work with this girl had assumed emotional disturbance, and the cause of her lack of speech was so much more straightforward! It was good to get some recommendations to the management of that daycare to help this girl get the language help she needed. I knew it would help to let her spend time with a Chinese teacher who knew both Chinese and English.

In another case, I got to work with an autistic girl. I was told she was terribly shy, and that she never talked with adults she didn’t know very well. (For some reason, kids that “don’t talk” often talk to me. It used to surprise me more. Sometimes, it still does!). I don’t remember how we got to talking — maybe she had a doll and I inquired about the doll’s name. Anyhow, she got to telling me stories. I started to notice a theme in the story she told. She was talking about a man, Arthur, who got older every time she talked about him. “Arthur is 50 years old. Arthur got a new boat because he turned 60. Arthur is 100 years old!” The main theme to her stories seemed to be the man’s aging. I think he may have been 200 by the time the play stopped! I didn’t really know this girl’s story — we’d only just met. But her mom and the girl and I were together, and the girl suddenly said, “Michaela. My daddy died.”

Oh. “Where is he? Why did he die, and where did he go?”

I don’t even remember my answer, and I’m not sure the actual words were important. This girl’s mom hadn’t understood why she was withdrawn. She was withdrawn for the same reason lots of kids get that way: It was because she had something so important bottled up inside, that this question was eclipsing her play, her words, her ability to talk to people. Working with her and her mom on talking openly about Daddy’s death could signal a new start and help her to engage in life again.

And one more story: A girl I got to play with at a domestic violence shelter. At 4, her interest in play was lower than that of most 4-year-olds. We played for a bit, but mostly, she wanted to sit close to me. And talk. And talk. And talk some more.

She needed to talk about her mommy. She needed to talk about her daddy who wasn’t around anymore but who had been mean.

And she needed to tell me how scared she had been for mommy, and for her dog. She recounted various incidents, times when her father had terrified her. And she told me that she had been trying to figure out what to do if he came to hurt mommy again. She had a childlike but elaborate idea of how she would help them escape. She had so much on her mind, and was thinking things through so hard. I was struck by her articulateness, her alertness, and also how her childlike thinking and impulses had been stunted by worries for safety, worries for mommy. We spent lots of time together. And we talked to her mommy too, her mommy who was still just working to piece together what had happened with this man. When this girl spoke to me, it seemed that she’d already decided that her mommy couldn’t help herself or her daughter. So talking with this 4 year old often felt like talking with someone very precocious who had learned early that she needed to outwit the adults around her. Underneath all the words was an aching need for attention, for contact, and to know that things were safe. It would take some work before she could be a kid again.

I love working with children. They often play out their concerns, or talk them out using thinly disguised stories or symbols. Kids are resilient, and they’re eager to heal. They give us so many indicators of what they need, and often, it’s not that difficult.

I got to work with a child who had some medical issues that required surgery. There were a couple different concerns his parents had. The child’s concerns had some overlap with the parents’, but some of the things he wanted to focus on were different — as is often the case with kids! Here’s what he worked with me on:

1. He was afraid of hospitals, and very scared before and after the surgeries. They wanted him to cope better and recover more quickly.

2. This kid had once seen a police officer come to the house next door, and he had developed a strong fear of cops or any mention of cops.

When I played with this child, it often got to feeling very, very slow and tedious. I don’t remember the precise games he led. I do remember having to work consciously to keep my energy up. I sometimes wondered, when we first started playing together, if what we were doing was going to go anywhere. It took some time for this child to let me lead much. But it turned out to be so well worth it. After about 25 minutes of play (that felt to me like 2 hours!), he began to play out the biggest issue on his mind. A police car was coming, and the cop was about to hurt everyone. I had a car in my hand, and I said, “Oh, it’s a police officer. That makes me feel better, because I know he’s here to help.” Over and over and over again, we did variants on this scenario. The kid played the person terrified of the cop. He played the cop, who was vicious and mean and scary. I played both roles too. A few weeks later, he said to me, “Guess what?” “What?” I asked. He grinned. “I’m not scared of cops anymore. They’re here to help.”

Soon, he brought up the hospital fear. Stuffed animals began to need surgery. We rotated roles again, and often! I played the bear that needed surgery, and was scared of needles. I took a deep breath with the bear. I said, “I know it will hurt a little bit for a moment, but I know I’m safe. I’m going to take a deep breath, and I’m going to ask the nurse her name and maybe tell her a story.”

I modeled different ways of getting through the fear.

And then, I played the doctor. The nurse with the needle. The patient again.

He played all the roles, and with just a few times going through these scenarios, he was settling down, trying out different skills. The real reward came when his parents reported that his next surgery had gone without incident: He was a little scared, but acted much more in control at the hospital. And he bounced back after his surgery faster than they’d seen him do before.

And then, there was something else happening throughout our work together. Attachment. It came quite clear in one session, where he whispered to me, “I have something very important to tell you. But don’t hug me, okay?”

I promised not to hug him. He smiled shyly. “I love you,” he said. And then we played some more with some stuffed animals and some toy cars. His therapy was just about complete.

Author: Michaela Lonning

I'm a counselor in Corvallis, Oregon, and I work mostly with intelligent and sensitive people who are struggling with a sense of connection to themselves or in their relationships. Near Corvallis? Come see me. Not near Corvallis? I work with clients around the world via Skype: Come see me.

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