Part 3 “Getting Therapized”
by Tracey Turner-Keyser
Seeking therapy is NOT an admission of failure, weakness, uncontrollability, or lack of intellect. We consider the act of seeking therapy a smart move for anyone. We look forward to the day when our mental health gets the same attention, education, priority, and privilege as our physical health. Many people get an annual physical; few have ever had a mental health check-up.
For the couple considering adoption or in the process of building an adopted family we have tried to pass along, over our first two articles, what we believe to be important points, important checklists, important issues, and important perspectives that can aid these processes. Throughout, we have tried to emphasize two critical points: 1) the necessity of taking care of you and 2) the guidance and support that can be offered by a trained professional therapist.
Let’s review why we suggest getting a good therapist from the start. Typically children who are in the foster/adoption system have learned that they can only rely on themselves. They have honed skills that allow them to feel safe, calm, and cared for all on their own, without healthy parental figures. Once placed with true loving and caring parents who provide a safe environment their authority over themselves becomes challenged. And no one likes to have their own authority challenged at any age. Here, in our last of our three articles, we delve deeper into the process of therapy so that there are fewer surprises, fewer heartaches, and greater potential for progress.
Are you ready to get therapized???? Consider the following.
1. Perspective and mindset sets the tone. The decision to seek a therapist or to enter into therapy is not something that should stigmatize the individual or family. We do not perform surgery on ourselves. We do seek professional help in issues of plumbing, tax preparation, medicine, lawn care, legal representation, etc. and seeking a good therapist is an educated, smart, and beneficial decision. Get excited about the entire process. Celebrate the opportunity to do things differently, to stay a step ahead. Look and feel positive about this!
2. Picking the Therapist: Experience and strong referrals are two important pieces in choosing the right therapist. Network, talk to other adoptive parents, check out websites. Unfortunately there are too few therapists who want to deal with adoption, attachment, and traumatized children and even fewer who specialize in this area. A few good resources are the North Carolina Foster and Adoptive Parent Association (NCFAPA), the ATTACh Organization, and Nancy Thomas’ web site that allow for networking and seeking qualified professionals. Once chosen make a ‘meet and greet’ appointment to make sure you feel comfortable and can follow-up on certifications, trainings, and qualifications. The therapist should have a detailed understanding of trauma processes, developmental effects of trauma, and an understanding of the potential for the act of saving a child from a traumatizing environment as being a trauma event also. The therapist should be strong, authoritative, kind, consistent, and empathetic (just like a parent should be). This sets the stage to establish safety and caring that the child will realize over the first several visits. The therapist should not befriend you or your child. The nature of this work requires honesty and clarity of communication that can sometimes be difficult to hear – the therapist needs to maintain professional distance so that what needs communicating gets communicated. If your child likes the therapist more than they like you then your problems will be multiplied.
3. Philosophy of Treatment: Philosophies of treatment will vary from one therapist to another. Here we present our philosophy and approach. The goal of therapy is to establish healthy relationship. The priority of relationships is 1) parent to parent, 2) mother to child, and 3) family relationships. This mirrors the natural process of family building: two people fall in love, decide to create family, fall in love with their child, and build strong healthy family. This takes time and planning. An integrated team approach is best. The team will consist of the therapist, parents, immediate family, psychiatrist (if needed), social worker, and school teachers. Parents will need to be educated, and time to practice. The significant adults in a child’s life will need briefed and possibly trained. There is no one treatment plan that works for all. Given the uniqueness of the child (or children), the uniqueness of the parents, and the uniqueness of what each brings to the family each specific treatment plan must be composed specifically for your family. Above all, the significant adults in any team need to support the basic tenet of therapeutic progress: the mother-child relationship is more important to the child than their relationship with the child. If any adult is undermining the authority and importance of the mother-child relationship then therapeutic progress will be significantly compromised.
4. Therapy is a Family Event: True trauma healing and strong family building requires the participation of all family members. A therapist can not ‘fix’ your child and give them back and all will be well. Some sessions will be for the entire family – some not.
5. Expectations: Therapeutic success is hard to measure. Without therapeutic intervention the effects of trauma grow over time. The health of a family will also continue to worsen with time. A traumatized child or a family dealing with the effects of trauma can be experienced as a never ending downward sloping road – this road can be thought of as your family or your child. This is a progressive state – over time it will get worse – it will continue to be a downward sloping road. The first signs of progress will simply be a sense of hope, a sense that you are understood by your therapist, a sense that you are moving in the right direction. Next may be a sense that the slope of your road gets less steep. Over time that road will come close to flat and then begin to climb upward. How long does this take? Firstly – understand that typically things get worse before they get better. A good therapist will establish an environment of safety and caring and then begin to address old trauma scars. When trauma scars are addressed there is a natural resistance to the process and things may seem to get worse. This applies for the child and each member of the family as their anger may surface prior to healing. No one can accurately predict the length of time needed for maximal therapeutic progress but we always suggest planning on dedicating six (6) intense months to therapy and then waxing and waning with therapy over the next twelve (12) months so that a goodly portion of eighteen (18) months is flexible enough for therapy accommodations and family practice. Maybe more, maybe less.
6. The Variables: There are endless numbers of variables that can affect therapeutic progress, maximal therapeutic progress, and time needed. We teach two sets of variables – static variables and dynamic variables. Static variables are things that no one has reasonable control over. Examples of static variables can be fetal alcohol syndrome (FAS), heavy metal toxicity, traumatic brain injury (TBI), addictions at birth, developmental anomalies, other medical issues, etc. These variables lead to permanent or near permanent changes that compromise potential maximal progress. It is best to lower expectations of potential maximal progress and increase expectation of time commitment when you have these variables present. It is best to expect less and be surprised with more in cases like this. Dynamic variables are variables that we do have some level of control over. Examples of dynamic variables are team compliance, frequency of therapy, therapeutic modalities, boundaries, respite care, etc. Optimal control of these variables can lead to greater potential maximal progress and less time.
7. Therapeutic Modalities: Research has suggested that movement is very effective in healing trauma (the source). Other evidence-based modalities applicable are Eye Movement Desensitization and Reprocessing (EMDR), dialectical behavioral therapy (DBT), drama therapy, dance movement therapy, therapeutic yoga, story telling, and group therapy. There will be a variety of modalities used in therapy depending on the specific treatment plan and the chronology of progress (i.e. what the client is ready and primed for). Your therapist should be able to discuss these modalities with you and explain the process and benefits.
8. Take Care of You: Follow your therapist’s guidance. Recognize the need for respite care (i.e. time away from your child), the importance of intimacy with your partner, the importance of alone time, and the importance of realistic goals. And above all, the importance of finding joy in your child.
So, are you ready to get therapized? We hope that you have found these articles useful and enlightening. We have enjoyed your readership and encourage all of you to contact us with your questions and comments.
Remember – the health of any child in any family can only be as healthy as the health of the relationship of the parents who guide and love them.
For more information or comments please contact us, or call 919-545-9833.
Gregory C., PhD Keck. June 2009. “Parenting Adopted Adolescents: Understanding and Appreciating Their Journeys”.
Gregory Keck and Regina M. Kupecky. April 2002. “Parenting the Hurt Child: Helping Adoptive Families Heal and Grow”.
Gregory C. Keck and Regina M. Kupecky. May 1998. “Adopting the Hurt Child: Hope for Families With Special-Needs Kids : A Guide for Parents and Professionals”
Leslie, Katherine. “When a stranger calls you Mom”, Brand New Day Consulting.
ATTACh Organization website:
Trauma Center at Justice Resource Institute, Dr Bessel Van der Kolk, Director
North Carolina Foster and Adoptive Parent Association (NCFAPA)