While most parents approach the role ofparenting with good intentions and the best desires for their children, not all have learned, or had appropriate role models in, effective parenting skills. If we look at the specific area of children with conduct issues, Dadds, Maujean, and Fraser say, "Conduct problems of aggression, stealing, non-compliance, lying and rule violations are among the most frequent referrals to mental health clinics for children and adolescents" (2003, p. 238). While there is a range of risk factors for conduct disorders that cover the epidemiological, developmental, social, educational, and other types (Loeber & Farrington, 2000), Dadds, Maujean, and Fraser are quite specific when they say, "A wealth of research has shown links between parenting style and child behaviour, and the development of conduct problems in young children" (2003, p. 238). In fact, they state that perhaps the most well-established risk variable is exposure to problematic parenting. Brinkmeyer and Eyberg concur when they say, "The combination of poor parent-child attachment and poor child behaviour management skills predicts more severe disruptive behaviour than either factor alone" (2003, p. 205). What this means in practice is that, ifa child comes into our office with conduct problems, whether they are simple annoyances to the family or something as significant as an act of criminal behavior, by and large the causes are likely to be found in the parenting styles with which they have been raised and, if this is so, it is toward the parenting style that therapy is best directed. Scott Sells, in an article entitled "Getting Through to Resistant Parents," is also specific when he says, "Parents who lack good parenting skills tend to respond to their children's bad behavior by repeating the same, ineffective methods—threatening punishment, raising their voices, nagging, etc." (2003, p. 27). Ifwe think about what this means in terms of treatment, it quickly falls back to one of the old adages in pediatric psychotherapy: You work with the parents and their parenting skills rather than the child. Sells draws the conclusion that one solution is to show the parents "how to stop an out-of-control kid with a step-by-step road map," with the therapist adopting the role of a "family coach" (p. 27). Helping parents change their behavior has a strong likelihood of helping children change theirs.
There are a number of approaches, with good empirical validation, for modifying parental styles in child management (e.g., Brinkmeyer & Eyberg, 2003; Sanders, 1999; Webster-Stratton & Reid, 2003). Some authors, such as Selekman (1997, 2002), see the family as the appropriate unit for change rather than the individual child or parents by themselves. While there is a sound rational and empirical basis for parental and family interventions, they do not fall within the scope of this text but are important to bear in mind by all child and adolescent therapists.
Let us say a parent brings a child to your office with a problem of nocturnal enuresis, but you soon discover the child is lying awake at night, too frightened to go to sleep or go to the toilet, because Mom and Dad are fighting. Where does the problem lie, with the bedwetting child, or the fighting parents? And who is your client? Here I can do no more than spotlight this problem as one that child and adolescent therapists need to be mindful of, and suggest that metaphors for the parents may be a helpful method for gift-wrapping the message of change and improved parenting skills in a way that engages their desire to overcome the problem. Depending on the circumstances and the players, it may be possible to introduce a metaphor along the lines of, "Recently I saw another boy about Johnny's age who was experiencing a similar problem of bedwetting. Of course, there are a number of good therapies to help with this type of problem now, and Johnny's parents were eager to see it fixed. I found it interesting when they raised the question of what they could do to help, so we began to discuss the possibilities. If I asked you, what would you guess are the things they discussed? . . . And the ways they suggested to help resolve them? . . ."
Planning and presenting stories for working with parents or families on problems in the parent-child relationship, or with parents who are a risk factor in the child's presenting problem follows the same principles that were discussed in the preceding chapter about preparing and presenting healing stories for children. If you would like to find out more about working with metaphor therapy for adults, you may find Lankton and Lankton (1986), Kopp (1995), and Burns (2001) useful books.
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