The endeavour of child psychotherapy is to eliminate the hindering factors of the child’s development and to restore developmental opportunities. The aim is to make qualitative changes to the relationship between the child and his/her parents or caregivers, let the potentials inherent in this relationship come to light and to extend the sense of competence of both the child and the parents. Another goal of the psychotherapy is that they gain such skills that will help them to solve their problems on the long run.
Through their different symptoms, children may present that their development has been hindered by certain obstacles, they cannot express their emotions and for that reason they need help. Symptoms may depend on the age, personal sensitivity and the child’s environment as well. Symptoms caused by mental strain may often appear in form of physical conditions (psychosomatic symptoms), which can also be the effect of the child’s not yet sufficiently developed language capacity. It should be noted that a mental disorder can never be considered an outcome of a single cause only, but it always implies an interaction of a number of factors.
In young children we may experience common symptoms such as parent separation anxiety, sleep disturbances, eating disorders, symptoms related to potty (toilet) training, nail biting, hair pulling, physical symtoms of psychiatric origin (enuresis – repeated inability to control urination, encopresis – fecal incontinence or soiling, abdominal pain, eczema, asthma, allergies, etc.). Symptoms like aggressive behaviour, social integration difficulty, communication problems (inability of speaking in certain social settings, stuttering) may also appear.
Typical symptoms of children in elementary student/preteen age are behaviour disorders, social integration and learning difficulties, social relationship problems with the contemporaries and physical conditions with psychiatric background, like eat and sleep disorders, tics or stuttering.
Most common symptoms in adolescence are relationship problems with the contemporaries, self-abusive behaviour and anxiety (compulsion, tics, panic, phobias).
Parents are most likely to look for psychological help when the symptoms appear or when the specialists do not find any explanatory reason of organic origin for the symptoms after completing an examination. The child does not necessarily suffer from the symptoms but the family, the parents are always worried about the manifestations of the child.
Child therapy is performed with the help of the child’s most natural language – play. The characteristic feature of the modern, analitically oriented child therapy is the relational approach/priority. This means that personality development, self-knowledge in the relationship with other persons will be realized through the sharing of adventures, thoughts and feelings. A secure, predictable relationship can only be grounded if meetings are regular. Relationship with the parents is also a principal part of children’s therapy, as the development of the child arises in relation with and depending on his/her environment, so changes in the child’s behaviour cannot be achieved without the supportive attitude and motivation of the environment. This is the reason why the parents’ commitment to the therapy is indispensable too. Pediatric therapy implies an encounter with the child once a week or less often more times a week, while with the parents once a month.
Adolescence is a normative psychological crisis, when the young person undergoes huge development, physical and mental changes. This is a very receptive period from the perspective of psychotherapeutic point of view, but at the same time the emotional fluctuations, detachment ambitions, which are typical for this age group, also present challenges to the therapeutic process. The short therapy (Four-Seat Adolescent Consultation) can already be well applied in this age group and proved to be very productive owing to openness and receptivity to changes.
Child and adolescent therapy in practice
First interview with the specialist is subject to the parent’s prior booking/ confirmation for the psychotherapy consultation. In the case of a small child, the meeting is held only with the parents, after the age of 14-15 years we arrange it together with the parents and the young person. Aim of the talk is to get acquainted with each other and to get to know the problem.
The first interview is followed by the so-called psychodiagnostic phase, which takes appr. 3-5 meetings, and after that a consultation is arranged with the parents or together with the young person.
By getting to know the problem, if necessary, we suggest psychotherapy. It is hard to predict the possible duration of a psychoanalytically oriented child therapy; certain symptoms can be resolved in a shorter time but in some cases resolution may take up to 2-3 years.