Parent Goal 3: Recognize the Child’s Stressors

, Julia Doss², Sigita Plioplys³ and Jana E. Jones⁴

(1)

Department of Psychiatry, UCLA, Los Angeles, CA, USA

(2)

Department of Psychology, Minnesota Epilepsy Group, St. Paul, MN, USA

(3)

Department of Psychiatry, Northwestern University, Chicago, IL, USA

(4)

Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

Keywords

Child stressorsParents’ perceptionsAwarenessSensitivityActive listening

How to Help the Parents Recognize the Child’s Stressors

To help achieve this goal, consider the use of the techniques described below.

How to Identify the Child’s Stressors

Remind the parents that they are your co-therapist and that you need them to understand what the child is struggling with and to help the child problem-solve. Make them aware of behavior changes that might signify that the child is struggling with something, such as becoming isolative, less talkative, and more irritable, as well as crying easily, eating less, and sleeping poorly.

Encourage them to check-in (as described in the parent communication goal in Chap. 11) with the child when the child demonstrates any of these behaviors. The child might then talk to the parents about ongoing stressors or difficulties. Provide the parents with the language they can use to let the child know that they are aware of a stressor and want to help the child manage it. For example:

Parent: How did the math test go?

Child: Okay I guess.

Parent: I know your math grades haven’t been so good. Should we try to figure out how to help you with math?

Parent: I haven’t heard you talk about any of your friends lately.

Child does not respond.

Parent: I know that you’ve been struggling with … lately. I am here to talk about it whenever you want.

Only with permission from the child, inform the parents about the child’s stressors that they are unaware of or have ignored. The lack of awareness about these stressors might make the parents respond defensively. Please see the dialogue below for suggestions on how to manage this defensiveness and help the parents understand the child’s perspective on his/her stressors.

Proactively Manage New and Unexpected Stressors

The parents need to be mindful of the child’s schedule and commitments prior to adding to the child’s responsibilities and increasing their demands from the child. This is particularly important at times that are commonly more challenging, such as before tests and finals or when projects are due at school. Suggest joint sessions with the parents and child for stressors due to problems in the parent-child relationship if the child is not yet comfortable discussing them with the parents without you.

Dialogue: How to Help Parents Recognize the Child’s Stressors

This dialogue demonstrates the difficulty parents might have in recognizing their child’s stressors and how this can lead to parental resistance. It also emphasizes the importance of dealing with the parents’ resistance without countertransference by supporting them while at the same time highlighting the child’s difficulties. It illustrates how to create a holding environment by validating and respecting both the parents’ experience and the child’s stressors.

L is a 15-year-old freshman in high school (yellow bubbles), who has been in therapy for 6 months for treatment of his PNES and associated symptoms. L’s parents presented for a family session today. Although L has not experienced any episodes in over 3 months, he has exhibited symptoms of depression. Namely, he began to be more aware of feelings of sadness and fatigue. His parents (mother = green bubble, father = orange bubble) noted increased irritability and a tendency to withdraw to his room early each night. His interaction with peers has steadily declined since the onset of his PNES. While his parents feel positive about his episodes being under control, they have become concerned and somewhat frustrated by these new behaviors.

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