Attended thought-provoking child psychotherapy conference at Emory this past weekend. The main case presented was of a very bright child with various worrisome symptoms who benefitted greatly from intensive therapy over a 3-plus year period. Therapy provided this kid with a safe environment in which to work out feelings about the father’s mental illness and his behavior, and helped the child avoid dad’s illness. The patient was also able to work on other intense feelings, like anger and resentment at a younger sibling for being born. These gains were achieved without resorting to medication.
Both parents had personal experience with the same kind of long-term intensive therapy their child received, so they understood and appreciated its value, which is impressive in this age of managed care and its emphasis on the shortest, cheapest treatment possible, often at the expense of the patient’s emotional development.
The therapist was in touch with this child about 10 years after the end of therapy. The patient is now very close with their sibling, did not fall apart emotionally when the parents separated for a time, has consolidated a sexual identity, and is now attending a top university, amongst other gains. I wish more parents knew about the lasting benefits of intensive therapy for kids for whom this is the best approach.
It was a beautiful case presentation that illustrated many issues that therapists think about all the time, like when the patient needs to understand something about how their mind works versus when the person needs the therapist to relate to them in a particular way in order to make progress; how therapy with adults is different from and similar to child work; and the somewhat different approaches child therapists have working with kids in intensive therapy. It has been clear to me and to similarly trained colleagues for many years that this kind of therapy really works when it’s done well, sometimes without medication, and always without putting superficial band-aids on people’s emotional lives, whether that person is a child, adolescent, or adult.