Wednesday, June 3, 2009

Ones I'll always remember

Remember when I blogged about Evan and his awesome family? Well, they just solidified their status as "ones I'll always remember" today.

Last week I told Evan and his parents (Connie and Ken) that I was leaving the agency and that they would be transitioned to a new counselor. Neither reacted to this information very well, they were somewhat irritable about the change. But after some discussion they made it clear that their concern was about what effects changing counselors might have on their son - who doesn't take well to changing anything.

I could understand that.

After talking a little bit longer they were also able to say they were feeling anxious about having to tell their whole story again. I've been meeting with the parents separately to help them work out the issues they have with each other, the divorce, and trying to co-parent their three kids. Both parents have been brutally honest with me and I've been continually amazed at their commitment to working things out for the best interests of their kids.

It's also been interesting for me because its really the first time I've ever done anything remotely like "couples counseling". I'm a kid person. I've learned to be a "parent" person. But, being a "couples" person has been a growing experience for me! As I've said before, getting one parent in with a child for therapy is a challenge - much less two! I'm glad this couple was my first experience.

To help you understand where I'm coming from, let me explain the mental health system in my area. Sadly, most parents who come to our agency have a "fix my child" mindset. Even more often is the "medicate my child" mindset. Very seldom do I get the "lets form an open and trusting relationship so that together we can help my child" mindset. A lot of that comes from the situations that I ranted blogged about in this post. I also think a lot of it has to do with all of the advertisments and commercials that run on TV for popular psychotropic drugs... but that's a rant blog for another day.

I work from a reflective and relationship based approach. I've been able to form those relationships with some families - they are generally the ones I feel like have been the most consistent in attending and also the ones that have made the most progress. Up until today, I couldn't have told you for sure if I'd really made that connection with Evan's parents.

So, after talking with them for a while during Evan's session, we decided it would be good for the parents to have their own "final session" with me. So, they came in today to get some closure and talk about the best next steps for Evan's therapy.

As soon as the parents came in I could sense the tension coming from Ken. This isn't terribly unusual - he's a bit 'high-strung' and it wouldn't take a genius to see where Evan gets some of his inflexability! Dad will be the first to tell you that he doesn't like change either.

Note: Its always important for me to remember to be conscious that I don't let Ken's anxiety make me feel anxious. This is a common pitfall for therapists (and people in general!) - letting their clients feelings effect them to the extent that the therapist takes on those same feelings. (See: Countertransference and Projective Identification)

I find this pretty easy with children - after all, just about any child - mental health issues or not - has less control over their feelings than an adult. Its our job as adults to regulate the children under our care. I generally feel pretty competent that I can maintain my own emotions and behavior and subsequently, the child's emotions and behavior in a session. (Check out this article on developing detachment.)

But, with an adult, things are often a little bit harder for me. This probably isn't made any easier by my lack of experience! Anyways...

So, when they first came in we started talking about their concerns for Evan and how we could make the transition easier for him. (Having me introduce him to the new therapist, taking him down to see her office, etc) But after just a few minutes, something major happened.

Ken started to cry.

That's right - the full grown, working class, tough guy, mechanic-type man began to cry in my office! Yikes!

After a few minutes of letting him compose himself, he was able to tell me that he really hadn't realized how much this change was affecting him as well. He had thought it was all about wanting what was best for his son, but it had become obvious to him that it went deeper than that. He confessed that he'd not been totally 'sold' on the idea of therapy when they'd first brough Evan in for the initial assessment. And, even after they started meeting with me separately, he still had it firmly in his head that it was still all about Evan. Until he found out I was leaving and he had to think about starting over with a new therapist.

It is always my first instinct to try to "talk them out of their feelings". But I know that isn't really helpful. Once again, its part of my job to model how to use people for support and have relationships in an appropriate way. And part of having real relationships with people is sometimes having to leave those people or let them leave you. Most relationships don't last forever - and that's okay!

So instead, we talked about all the things that we've shared together - which hopefully normalized Ken's feelings. We also talked about the realities of how difficult it might be to re-hash some of those feelings. I encouraged them that, now that they knew the benefits of being open, it may be a little bit easier. We also talked about how great it is that they could come in and process their feelings appropriately - because that is the biggest protective factor for Evan.

We actually talked about that a lot - and this is why this family will always have a special spot in my social work journey. I've seen so many children that have experienced traumas that I can not even comprehend. And the ones that have the best chance at successfully coping and overcoming these events are the ones that have a secure attachement to a caregiver that is able to support them through the various ups and downs of life.

I am looking forward to my last session with Evan and his parents next week - with a little bit of bittersweetness. I worry about their journey through the trials of the mental health system, but I think these two parents are going to do everything in their power to make sure that Evan is supported and protected. Evan is so blessed to have two parents that, although they could not work out the differences in their marriage, are working diligently to minimize the trauma of their separation and to figure out ways to best support the challenges that come with his personality and possible mental health issues.

And I am blessed to have learned from working with them.


  1. You cherish and truly care about your clients, it's so refreshing!

  2. This post speaks volumes about your character. Volumes!!!


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