Collaborative Therapy is Essential to Children's Mental Health
Our organization supports the healthy development of children who are experiencing significant mental, emotional and behavioral challenges at school. We believe that schools are the best place to address and treat children with mental health challenges because that’s where children spend the majority of their time – it’s where they learn, socialize, eat, and grow up.
Therapy which takes place within a school setting is convenient for families, parents and teachers as it allows them to be included in the process and assists therapists to better understand the children by observing them in their school environment. It’s also a place where collaboration can happen more effectively. And in our experience therapy is most effective when it’s collaborative, supports relationships, increases communication and reduces stigma.
Putting Relationships First
Children are born into relationships. From their very first moments they affect and, in turn, are affected by, their parents and siblings. As children grow, they have more and more relationships that are powerful and defining – relationships with extended family members, friends, neighbours, and teachers.
How children function in these relationships and to the extent they experience them as rewarding and pleasurable, will profoundly affect their self-esteem, sense of belonging, and sense of competence. It’s also directly tied to their motivation to learn. Generally, children are happiest when they have positive relationships with people who are important to them.
Many parents with children experiencing mental health difficulties feel embarrassed, ashamed, and overwhelmed by the negative reports from teachers, principals, and social workers, no matter how tactfully or kindly they are delivered. Having consultations with therapists at school encourages parents to express their concerns, and feel more comfortable. Therapists actively work toward building bridges between teachers, principals, and parents knowing that when the therapy ends, there will be a community of adults to provide continuity and support for the child.
Collaborating with Parents, Caregivers and Families
There was a time when professionals believed that information should only flow one way with respect to children’s mental health – the therapist or doctor would ask parents many detailed questions but provide little information in return, would not invite parents into the room, and wouldn’t even speak to teachers.
Although parents would never consider leaving their children alone at a dentist or pediatrician, they were routinely asked to leave their children alone with mental health professionals they didn’t know. When parents are brought into the therapy process, they can provide so much insight into their child’s functioning, behaviour and relationships because parents know a whole lot more about their child than anyone else.
Working together, parents and professionals can gain a better understanding about the child’s thoughts and fears, and how to help children feel and manage better. Also, when parents are included in the process they can develop expertise about their child’s condition, whatever it is, and use that expertise to continue to help their child after the treatment period is over.
Many of the families we work with come from countries where institutions are viewed with apprehension and fear, and they are wary of becoming involved in the school community. Others grew up in Canada but have unhappy memories of their school days and they, too, are reluctant to participate. Collaborative therapy invites them to the table to participate and increase trust between all parties involved.
Collaborating with Teachers and Schools
Teachers are also very important, both as sources of information and also as collaborators in bringing about changes for the child and within the child. Children spend a huge amount of time in school, and how well they learn, play, and get along with their peers and teachers has an enormous impact on their self-esteem and happiness.
Teachers have a front row seat when it comes to how children interact, manage conflict, and their willingness to take risks, or not. Children can behave very differently at school than at home and it’s so important for mental health professionals to know if and how they do.
Teachers are busy and have many competing demands-first and foremost the curriculum but also, how their class of up to 30 children learns best and functions as a unit, individual children’s progress and well-being, lunch room and recess duty, staff meetings, and addressing the concerns of principals and parents.
Given all of this, they find it particularly challenging when one or two children take up most of their energy and time because they are loud, disruptive, or can’t follow directions. Finding empathy for these children is hard, especially when teachers have no information about their lives and predicaments… which is most of the time.
Collaboration Leads to Empathy
We have found that teachers benefit significantly when they know that children are experiencing stress at home because of parental conflict, unemployment, or poverty, that the family is being investigated by immigration or the Children’s Aid Society, that dad is in jail, or that he or she has suffered abuse.
Knowing this provides perspective and allows for the possibility of greater compassion. The child’s angry outbursts can then be reinterpreted as expressions of fear and anxiety; their failure to listen as preoccupation and worry about an uncertain future. In addition, when parents give permission for therapists to reveal these important stressors to teachers, it relieves the burden of secrecy that always compounds children’s distress.
Children who are stressed and in distress often can’t say or don’t know what’s causing it. When therapists, teachers and parents communicate they can often identify the provocations that led to a child having an outburst, withdrawing, or developing headaches or stomach aches-physical symptoms which are frequently associated with emotional upset in children.
Collaboration Reduces Stigma
When our charitable organization first offered school-based treatment for traumatized and maltreated children, many principals and teachers worried that children removed from class for therapy would be stigmatized but they were willing to give it a chance because it saved so much travel time and allowed teachers to be involved.
Everyone was surprised to discover that the classmates of children receiving treatment were much more patient and kind to them, as a result of the treatment. Rather than viewing these children as “problems”, they started seeing them as children with problems. And not a single child receiving treatment expressed embarrassment at being withdrawn from class. On the contrary, they were delighted because it made them feel special and their peers were envious!
All this to say that collaboration and information sharing are really good practice when helping children, whatever the problem. Children like the important adults in their lives to talk about them, especially when it means something will change for the better. They just don’t like it when information sharing results in their getting punished, as in “wait till I tell your mother.”
If we are going to reduce stigma about mental illness, we need to talk about it openly, teach children early about anxiety, depression and stress, give them permission to talk about it, and share information with teachers, because teachers can help.
Summary
Children benefit enormously by having their parents, teachers, and therapists work together to help them learn new ways of coping, adapting and relating. When therapy is accessible, inclusive and collaborative it helps everyone involved.
About The Author
Janet Morrison, M.A., C. Psych Assoc. is a psychological associate in private practice and a senior lecturer at the Factor-Inwentash Faculty of Social Work, University of Toronto. Over the past 30 years she has assessed, treated and supervised treatment of children in long-term care, as well as, consulted for Children's Aid Society and group homes across Ontario.