Working with Children in Therapy: Practical Guidance for Therapists

Working with children in therapy often means working with their parents too. In this guest article, respected children’s hypnotherapist and author Lynda Hudson shares practical advice on involving parents in therapy, supporting progress between sessions and deciding when a parent should be present.

I give introductory workshops to therapists on working with children in hypnotherapy. One of the aspects that therapists often find daunting is how to deal with the parents of the children. It is also an area that often provokes a lot of differing opinions and lively debate. So I thought it might be a useful topic to write about.

Common Concerns When Working with Parents in Child Therapy

Can Parents Accidentally Undo the Work?

I think this is a very valid concern. Even with the best of intentions, parents can ‘bring the problem back’. They can use too much ‘problem talk’ and not enough ‘solution talk’.

They need to understand how to support the treatment. Firstly, by assuming that the child’s original problem has been at least reduced, if not entirely eliminated, by the work you have done. Secondly, this assumption has to show itself in the way they behave and the way they talk. Then they don’t put doubt into their child’s mind.

Therapy Case Study

One very anxious mother brought her child to see me. He gagged and refused to take his medication for Crohn’s disease. Without the medication, he risked needing to have an operation to remove part of his intestine. The mother had been present in the session, and had seen her son respond brilliantly. She had even seen him happily drink the medication with absolutely no problem at all. He had achieved an amazing result with lots of congratulations from me. There was an assumption that the difficulties were now over. The child agreed and was very happy.

However, his over-anxious mum’s response was to respond in a very hopeless tone. ‘Well, let’s hope this works because nothing else has, and then the only thing will be the operation’. Luckily, she said it in my hearing and I was able to dispel the doubt. In a subsequent telephone conversation, I was able to advise her on how to be supportive in her language.

This was a lesson for me! Don’t wait till after the event. Instead, explain to the parent prior to the session how you want them to behave supportively. This is so important that now I not only have a conversation before they come, I also give a handout. It has general ideas on how best to support their child in between sessions and also after completion of treatment. I frequently also have a follow-up telephone conversation with any specific advice arising from the session.

Should Parents Be Involved in Their Child’s Therapy?

When working with children in therapy, many therapists work from an assumption that the problem lies with the parents. Everything is their fault, and they should be kept apart from the process as much as possible.

Of course, it is possible that this fear could be partially true. But in more than twenty years of working with children, I have met many hundreds of parents. The vast majority have been loving, caring and very concerned for their children’s happiness and well-being. In my view, it is important to work with parents and not against them. Using NLP tradition I like to assume that parents have a positive intention until proved otherwise. In this way, it is easier for us to work together to get the best result for their child.

Even if they are unwittingly encouraging the problem behaviour, I believe that I can help everybody best by helping the parents to understand what is going on. And how they can play their part to the best of their ability. So, instead of banning them from the therapy room, particularly with young children, I encourage them to be there for at least part of the session.

Purposes of having parents in the therapy room

• People who take part in something are more likely to invest in the process than those who are excluded
• Parents can see that nothing ‘weird’ is going on and that their child is safe
• The child feels safe and derives comfort from the presence of their parent
• You are protecting yourself from mistaken accusations
• Parents don’t feel excluded and therefore possibly a bit resentful
• Very importantly they can learn from the ‘solution talk’ how to continue this themselves
• They can understand how I am trying to help the child

Having them there, for at least part of the session, can provide an opportunity to openly suggest new ways of parent and child interacting with each other. In fact it’s a bit of informal family therapy at times. Parents can be a wonderful resource for positive anchoring when their child doesn’t come up with an idea. If you ask the right questions, you can elicit positive and appreciative remarks about the child. This can be very gratifying and motivating for them to listen to

What If a Child or Teenager Doesn’t Want Their Parent Present?

Obviously, you need to be flexible. In the telephone discussion beforehand, I often explain that the parent is very welcome in my therapy room. However, many children (particularly older children) really don’t want an audience while they are experiencing hypnosis. Or won’t speak freely in the discussion part of the session. I ask them to let their child know in advance that they will be perfectly happy to wait in the waiting room. Or stay with them, whichever they prefer. And during the visit, I always make both the child and the parent feel at ease with the child’s decision. Another option is to have the parent there for just part of the session and this often works very well.

Does a parent have to be in the room with young children?

No, not at all. There is no legal obligation to do so and under the law, you are free to make your own choice. What I have said is my opinion, based on my experience and I find it works very well. For me, the advantages far outweigh the disadvantages.

Editor’s note. Requirements for working with children may vary according to your professional body’s code of ethics, insurer and current safeguarding guidance. Therapists should check the requirements that apply to their own practice.

Think about it before you choose though. One reason some hypnotherapists choose not to allow it is because they don’t feel confident being observed while working. I understand this, as I felt the same way at first. But confidence comes with practice and you can quickly get used to it!

Making A Parent Handout for Supporting Child Hypnotherapy

Earlier, I mentioned a parent hand-out. Here are some practical suggestions for helping parents support their child’s therapy between sessions:

The list is not exhaustive, and you may certainly want to add ideas or leave some out. You may also like to add advice specific to the issue or specific to the individual child. I would suggest that you don’t make a list too long or it could be very daunting!

What to include in your handout

• In the session, you will find that my focus is on your child. I talk directly to them and really need to listen to their answers. Then I can hear the words they use, and take account of the way they express themselves. It is really important that I do this. Please don’t be offended if I only turn to you from time to time.
• At home give credit for progress and effort.
• Try not to question them about the session. It’s usually better to let the child’s unconscious mind sort things out on their own.
• Think about your language; Put ‘problem talk’ into the past tense.
• Introduce ‘solution talk’.
• You can include the idea of learning a new way of thinking and doing things.
• Please don’t talk about ‘going back to square one’ … it is really de-motivating.
• Please don’t say ‘it isn’t working’. Try ‘you need a bit more practice / time’. Or ‘your brain and body need a bit more time to learn the new way’.
• Never blame or punish for things that are beyond their control.
• Assume the process is going to work and be positive.
• Don’t keep asking if they are alright or if they are frightened or worried. It puts it into their minds.
• Give the process time and don’t expect miracles overnight (even though sometimes you might get them!).
• Email you if they have a question. (You may or may not want to include this for obvious reasons!)

More about Working with Children in Therapy

Related CPD from Yorkshire Hypnotherapy Training

If you’d like to explore this topic further, have a look at YHT’s Hypnotherapy and Children course. It looks in more detail at working with children in therapy. It includes communication, safeguarding and practical considerations when working with children and families.