Families with Young Children: A Developmental-Family Systems Perspective
Intro:
- Children are intuitive guides to the shared unconscious of the family. They are honest, direct and their presence enhances the process of family therapy.
- Many therapist don't include the children in family therapy, especially the younger ones. And when they are included, developmentally appropriate adjustments aren't made so the children's voices aren't heard.
- Family therapy with children requires that therapist know about child and family development, developmental psychopathology, systems theory.
Demographics and Descriptive Statistics
- There are lots of children in America, of all different races and nationalities. 22% of them live in poverty. And they live in all kinds of families, parents together, step parents, single parents, divorced families.
- Therapist must develop expertise in working with multiple family constellations
Child Development
- Infancy and toddlerhood
- Infants are completely dependent on their parents. Consistency and responsiveness in caregiving are required for the development of secure attachments.
- Toddler hood is marked by burgeoning independence, learning to walk, start to communicate their needs, wants, and preferences through
- Preschoolers
- Language acquisition, use words to communicate.
- Still view events in an egocentric manner, the world is magical and animistic. Imaginative play becomes increasingly complex.
- Middle Childhood
- Marked by a shift from egocentrism to perspective taking.
- exhibit increased mastery of their bodies, channel self-expression through involvement in sports, the arts, and other hobbies. Peer relationships become more prominent.
Family Development
- Common tasks for families with young children
- With the arrival of children, parents now have to change their role definitions. Who works, who cleans, having adult relationships, etc.
- Caregivers must learn to provide consistent nurturance without themselves becoming depleted, and find new forms of emotional gratification in the act of caregiving.
- As children get older, the family must be flexible, and parents take responsibility by setting limits and exerting authority.
- Dynamics for different family constellations (how adding children changes things)
- Intact families
- two parent families
- the couple has to find ways to maintain "couplehood"
- renegotiation of family roles and responsibilities
- Single-Parent Families
- the demands of caring for a child or children by oneself can be overwhelming, both pragmatically and emotionally.
- Extended family members often play a vital role in care of young children.
- Extended Family
- Extended family members can serve as caregivers, often grandmothers.
- more common among certain ethnic groups.
- Divorced, Step, and Remarried Families
- lots of stresses: single parenthood, complexities of coparenting, custody and visitation, remarriages which bring there own challenges.
- Adoptive and Foster Families
- bonding, age of the adoption, forming a family story about the adoption, divided loyalties, managing the child's curiosity about their biological family.
- Foster families deal with similar issues in addition to uncertainty of the length of placement.
- Gay and Lesbian Families
- Blended families, how did the child come, surrogacy, adoptions, a biological parent is out there. These couples experience intense societal prejudices.
Common Presenting Issues In Families With Young Children
- Child Problems
- Behavioral Problems
- ADD, ADHD, ODD, tantrums, overactivity, destruction of property
- Remember, disruptive behavior frequently reflects underlying emotional distress a a reaction to environmental stresses.
- Emotional problems
- Depression and anxiety are most common.
- signs: social isolation, limited peer involvement, fears, withdrawal from activities, low self-esteem, low appetite, and sleep disturbance.
- School and Learning problems
- Behavioral and emotional problems may contribute to learning and academic performance problems.
- Learning disabilities often lead to low self-esteem and disruptive peer, teacher, and family relationships, contributing to the development of behavioral and emotional difficulties.
- Developmental Disabilities
- Mental Retardation and pervasive developmental disorders
- Physical Symptoms and Medical Problems
- Children are often referred from doctors due to physical complaints, symptoms, and disorders.
- Can run the gamut, somatic complaints, to coping with chronic medical conditions
- Links Between Child Problems and Family Dysfunction
- Children can create problems or children take on stress of the family and become problems.
- Family Problems
- Parental Relationship Discord and Conflict
- High correlation between child maladjustment and marital discord, particularly for boys.
- Separation and Divorce
- Psychological difficulties in children postdivorce are predicted by levels of interparental conflict. A lot depends on the childs contact with both parents, the child's anger, their ability to support their parents for help with emotional regulation.
- lower parent hostility and parental rejection combined with consistent and appropriate disciplinary practices equal better outcomes for the children, they adapt reasonably well.
- Remarriage
- Parenting Problems
- Family Violence
- Neglect
- Often child problems are because of child maltreatment, significant emotional, physical educational, or medical neglect.
- Parental Psychopathology
- Parents with psychopathology, their children are at a higher risk for various forms of maladjustment.
- Illness or Death of a family member
- Siblings Problems
Family Interventions For Young Children
- Family Therapy: The Treatment of Choice?
- Traditionally its been family therapy, but we are adding more modalities to this.
- When the child has sufficient ego strength, they can speak up, then family therapy might work.
- You may need to do individual and family therapy when:
- child manifest significant symptoms and the parents exhibit considerable psychopathology or marital dysfunction contributing to impaired parenting
- the parents are able to help their children with some but not all, aspects of their development
- the family engages in maladaptive interactions in response to the child's individual pathology
- the family exhibits inadequate role function and poor communication patterns
- Play in Family Therapy
- Focusing family therapy around play helps the family relax
- everyone of all ages can participate
- play lowers everyone's resistance to sharing and change.
- Ideas: Board Games, Family Puppet Interviews, Family art therapy, telling stories, family sculpting
- Child-centered Family Therapy
- short-term, developmentally focused, structural dynamic treatment intervention, uses a family-initiated model of system change.
- 5 structured activities:
- family notebook, family photographs, family network drawing, living sculpture, and family role play
- Parenting Training
- Helping parents become better equipped to deal with child's problematic behaviors
- usually focuses on 1. behavior modification and 2. relationship enhancement
- Parent-Child Therapy
- Do therapy helping the child and parent play together
- Two phases:
- child directed interaction
- parent directed interaction
- You help them learn how to interact, communicate, etc.
- Filial Therapy
- Therapy is a relationship enhancement intervention approach that incorporates client centered play therapy techniques.
- Basically you are help the parents become the play therapist.
- Infant-Parent Psychotherapy
- used primarily with high risk infants
- Three elements: 1. psychotherapy, 2. nondidactic developmental guidance, 3. concrete support.
Conclusion
- Although it is largely agreed upon that bringing children to therapy is beneficial, but therapist often don't include children.
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