Build on the Childs Resources and Positive Experiences

Perhaps the most important information you can gain for working with a child is to learn about his or her resources, interests, skills, and positive experiences. Undoubtedly, if you have spoken with the child's parents you will have heard about all the problems they see in their child. The child has no doubt heard this, too—many times over. It is likely to have been discussed at length within the family, to the point that the child is fed up with hearing it again and again. To continually remind a child of what is wrong with him or her does not necessarily give the child the skills to change and, certainly, does not enhance his or her sense of self-worth. For the therapist, joining in a discussion of the problems with the child runs the risk of triggering resistance on the part ofthe young client who, understandably, does not want to hear it all again from someone new. Once in this position, the therapist has lost potential therapeutic potency and will need to take a different orientation to be able to offer the hope of change.

Material that is likely to engage children, build on their resources, and give them confidence to move forward may be gained from a variety of questions that seek to explore their capabilities, strengths, and potential for making therapeutic gains. Such resource-oriented questions might include the following:

■ What hobbies do you enjoy?

■ What books do you like reading?

■ What is special about your favorite characters?

■ What are you favorite subjects at school?

■ Who are your closest playmates?

Let me give an example. I recently saw a 12-year-old boy (referred by his pediatric rheumatol-ogist) who had been diagnosed with a diffuse pain syndrome that involved debilitating symptoms following an automobile accident. He found it difficult to walk, stand, hold a pen, play, or participate in sports. He had stopped attending school, did not see his friends, and spent most of his time playing video games. His specialist had suggested a psychogenic element to his problems and was encouraging him, along with his psychiatrist, physiotherapist, and parents, to start doing things again. From a therapeutic perspective this was very appropriate, but Andrew (as I have called him in a metaphor based on his case, Story 88, "Getting Back on Your Feet") did not believe he could, and so was passively resisting all efforts.

Not wanting to risk our sessions' slipping into the same pattern, we talked about his past interests and hobbies, and how he might resume these when better. We explored ways, often in metaphor, of seeking to broaden, subtly and simply, the types of activities in which he could engage and to build this into a more extensive repertoire. I was deeply touched when, on leaving my office after one session, he looked me in the eye and said, "You know, you're a good friend." On that we had a basis to work.

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