My Perfect World: A Day in the Life of a Child Therapist
Imagine a world where you spend all day playing. Perhaps you would shoot hoops or play hockey. Or you might dress up your dolls or blow bubbles. Maybe you would paint a picture or play board games. When you tire of playing and need a break, you could spend time resting in your bean bag chair or relaxing in your very own tent. Sounds perfect right? Luckily for me, this IS my world… the world of a child therapist.
As a Clinical Social Worker I work with children between the ages of 3 and 18, supporting the occasional adult as well. Treatment options vary from client to client with most parents seeking either play therapy or hypnotherapy for their child. Regardless of the modality of treatment used, therapy is fun! When my “friends” come to my playroom they know they are in a safe and peaceful place, where they can try out new things, make mistakes (and be okay with it) overcome obstacles and feel good about themselves. The kids I work with are not treated as damaged or impaired; they simply practice new skills and strategies that help them feel happier and overcome obstacles to success.
What might a typical therapy session look like? Sessions are structured in a way that allows predictability for my young clients; many of whom are diagnosed with ADHD or Autism. We have a brief “Check-in” to talk about the events of the week; engaging in problem solving or goal setting as needed. Next comes “Pick 4” with the child selecting four calming or mindfulness strategies to practice. Then comes the meat of the session where we work on the presenting problem.
In a recent session, with a 3-year-old I will call Tim, we engaged in play therapy to address issues with self-concept. Tim, who is typically a sweet, gentle boy, considered himself a bad boy after becoming physically aggressive with another child at his pre-school who had been hitting, kicking and biting him. He showed signs of anxiety through crying, clinging to mom and refusing to go to school. In the initial session, Tim started a game of “Good Guys, Bad Guys” using my toy Super Heroes (the good guys) and dinosaurs (the bad guys). In the game, the purpose shifted from session to session, with the good guys becoming bad, the bad guys becoming good, everyone fighting etc. One session stands out as the most pivotal moment in his treatment. Tim became very serious and told Superman (the figure I was playing with) that he needed to tell him something. He leaned in and whispered “I’m not always a good guy. Sometimes I fight.” Superman, who is very wise and loves to help kids, told him “When I was a little boy sometimes I got into fights at school. I thought I was a bad boy, but my mommy told me something very important.” I could see the wheels in Tim’s head turning as he waited for Superman to share Supermom’s wisdom. “Everyone makes mistakes with their behavior,” Superman said. “But they are still good kids”. Tim thought about this for a moment, nodded his head, and the game was done. He had “played out” his issue.In play therapy, the act of playing is the child’s language and toys are the child’s words. In the therapeutic setting, children learn to communicate with others, express feelings, modify behavior, develop problem-solving skills and, as in Tim’s case,resolve inner conflicts; all through play. Tim and I have played “Good Guys, Bad Guys” a few more times since, but the focus has changed to the good guys helping the bad guys and everyone ending up as friends.
Another notable session involved the use of hypnotherapy with an 11-year-old I will call Amy. Our work together has focused mainly on anxiety related to social relationships. When she came in for a recent session, she was visibly upset, describing something that had happened at school that day. One of her longtime friends had given her “the look” at recess, then laughed and ran away. Other girls became involved and when Amy tried to stick up for herself the other girl told her she was over-reacting. This may seem inconsequential to an adult, but in the tween world an event like this is DEVASTATING! We talked through the situation, identifying the worst part of it, which was Amy’s fear that all of the girls would turn against her. We engaged in role-play to explore different ways to handle the situation if it continued the next day. Then we ended the session with hypnosis to strengthen her confidence and imagine handling future drama successfully. Hypnosis is a wonderful tool to use in therapy as it encourages use of the imagination. According to the American Society for Clinical Hypnosis, mental imagery is very powerful, especially in a state of focused inward attention. The mind is able to use imagery to assist in promoting change in thoughts and behaviors. Ideas or suggestion that are congruent with the child’s needs are given, and in a state of concentrated attention, this can have a powerful effect on the mind. The next session Amy reported communicating with her friend confidently and assertively and working out the problem between them.
Providing therapy for a child who is struggling is very important. Through the therapeutic relationship my “friends” are able to express themselves without consequence, explore the reasons for their behaviors, learn to shift negative thought patterns and manage their emotions; thus allowing for greater confidence and an increased ability to manage daily stressors. What do I get out of my work? Well, unbelievably I get paid to play all day (Remember that perfect world?) But, more-so, I have the opportunity to connect in a positive way with kids and make a difference in their lives. And that is priceless.
I am a clinical social worker with a private therapy practice in Bradley Beach, NJ. I offer hypnotherapy, cognitive behavioral play therapy, filial therapy and mindfulness based psychotherapy for toddlers, children, teens and adults.
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