Counseling a Child

The Child and Presenting Problem:
 

S.W. is an 8-year-old male child who I worked with for this assignment.  I met with him for 2 separate sessions, approximately 25 minutes each time.  A third session was scheduled, however S.W. became sick and was unable to come in for the following two weeks.  S.W. and I had established a relationship previously, as I have worked with him in the past in occupational therapy.  Each session, S.W. came with pressing issues he was willing to discuss.  During the first meeting, he spent time talking about grief regarding the loss of a family pet.  During the second meeting, S.W. was concerned about spending the Easter holiday with his grandmother, because of religious differences between households.

Some background information on S.W. includes that he lives at home with his mother, step-father, and younger half-sister.  S.W. has been diagnosed with developmental delay and attention-deficit hyperactivity disorder (ADHD).  He has significant difficulty processing and understanding auditory information, especially language, at times.  Additionally, S.W. has dyspraxia (motor planning) issues, causing him to appear slow and clumsy when moving.  Because of his speech impairments and dyspraxia, S.W. had been the target of much teasing from his peers.  S.W.'s family appears supportive, but his parents express frustration with some negative behavior that has recently begun (i.e. stealing from others, physical aggression).  Both parents work outside of the home, however, they indicate that money is scarce.


 






General Description of Counseling Sessions:
 

At the beginning of the first session, I re-introduced myself to S.W. and spoke briefly about what I was there to do (i.e. learn more about what elementary school-aged children are like, listen to things that you want to talk about).  I also explained that we would not be playing the usual games we played when he was in occupational therapy, because previously he knew me only in this context.  S.W. was occasionally distracted during the sessions and required verbal redirection to go back to the main point of his ideas.  S.W. required very little facilitation to begin talking about the loss of his family's pet dog.  Using open-ended questions I learned that he had been walking the dog, holding his leash, when the dog tugged away and ran into the street.  S.W. watched as the dog was struck by a car and killed.  When S.W. discussed feelings of sadness and guilt, I used 'how' and 'what' questions, and feeling-focused responses to further explore and validate his feelings.  S.W. then brought up that the family had a new pet dog, and S.W. expressed pleasure in the fact that he was able to chose the dog's name.  We spent some time talking about how the new family pet was similar and different from the previous dog.

During the second session, which occurred just days before the Easter holiday, S.W. expressed concern about spending the holiday with his grandmother.  Using open-ended questions and clarifying statements, I found out that S.W.'s immediate family practices a religion that does not celebrate Easter.  S.W. stated fear that he might die if he went to his grandmother's house.  After making feeling-focused responses, I attempted to use the problem-solving model (What is the situation?  What have you tried?  What else could you try?  What is the next step?).  However, I found limited success with this, as S.W. remained very concerned about being hurt when over at his grandmother's house.  Also, at times I wondered about S.W.'s ability to problem solve and gain personal insight.  We did come up with a plan and steps to follow for S.W. to discuss his concerns with his mother when she returned to pick him up.
 
 

Interaction and Dialogue:
Initially S.W.'s responses were brief, however, once he realized that I was actively listening they appeared to lengthen and become more descriptive.  This was especially evident during the second meeting, as S.W. took much less time to launch into his primary concerns.

Sample Dialogue (from first session):
 

T.L.: Tell me more about your new dog...

S.W.: Well...uh...his name is Lucky.  I got to pick his name.  But sometimes he bothers me because he wakes me up in the morning and tries to bite me, and I don't like it and I get mad.

T.L.: You're excited to have a new dog, but sometimes you don't like the way he behaves.

S.W.: Yeah...Linus (his previous dog) never did that.  He never, ever hurt me.

T.L.: Can you think of some other ways Linus and Lucky are different?

S.W.: Yeah...Lucky has black spots on his nose and a black foot, and Linus had black spots only on his back and front.

T.L.: So their coats are different...what else?

S.W.: They both like to lick my face, which, I just say "yuck"!  And Lucky likes to go for walks like Linus, but I ain't going to hold on to the leash no more because of what happened.

T.L.: You don't want Lucky to run away...so you'll have a grown-up walk him?

S.W.: Yeah, my dad will.  I'll walk close by.
 
 



Personal Insights:

I really enjoyed working with S.W. and getting to know more about him.  I was disappointed to work with him on only two occasions.  I felt really good that he was willing to share personal information regarding the loss of his dog with me, as his mother reported that he was very reluctant to discuss this with others outside of the family.  I was also pleased with how comfortable I felt during the sessions with S.W.; the questions and responses seemed to flow smoothly for the most part.  Perhaps it was because I had already established a rapport with this child.

I wish that I had more opportunities to work with S.W., as I feel he really thrives with the attention of a concerned adult.  I also think that, had we had more time to work together, he would have been able to learn some effective coping strategies with close coaching.  This experience really made clear to me how just being there to listen to a child can be a hugh bright spot in their day.