With adults, a typical counselling room set up will have counsellor and client sitting in two chairs opposite each other on a slight angle facing inwards; the client is encouraged to talk about what is happening with them.
What Counselling with Children Looks Like
This is not what counselling looks like when working with children.
As a counsellor primarily working with children, I rarely use the couch but rather use the floor. The floor provides a big space where different types of toys, games, etc are put out for the child to choose from. This is because children find it difficult to talk about what they are feeling and going through; research shows that children communicate through play. Therefore, play and toys in the counselling room have great importance and significance in the therapeutic journey.
Parents often ask me at the first or second session how long the therapeutic journey will take. However, that is a difficult question to answer as there are many factors that contribute to how effective the therapeutic journey is. A few of the variables to take into consideration are:
- The frequency of sessions. The more frequent and consistent sessions are, the more effective the therapeutic journey will be.
- Parents as partners in the therapeutic journey. Throughout the therapy journey, I will invite the parent in the room and I will often recommend some strategies to try at home. It can be helpful for the therapeutic journey if parents are willing to try different strategies that they might not have previously used.
- It is important for parents to consider that everyone’s journey is different as we have all experienced different situations. Therefore, as a counsellor I feel like I cannot say that your child’s therapy journey will be 10 sessions based off another child’s journey being 10 sessions.
- A major influencer to the effectiveness of the therapeutic journey is rapport building.
What is Rapport Building?
The first and most important objective of the therapeutic journey is the establishment of client rapport.
Good rapport between client and counsellor has been found to improve treatment outcomes. Research defines rapport as:
…conscious and active collaboration between patient and therapist”
A therapist relationship is a trusting connection and rapport established between therapist and client through collaboration, communication, therapist empathy, and mutual understanding and respect.”
However, unlike counselling adults where rapport can be built quite fast, building rapport with children takes time.
Building rapport with a child can take roughly two – four sessions. In these first sessions, I focus on providing a safe, non-threatening, trusting environment where the child can start to feel like they can talk, play out, and process what is happening for them in their lives.
In these exploratory sessions, it might not look like we are doing much, but we are building a sound foundation that will create the pathway for being able to have an effective therapeutic journey in future sessions. This will most likely involve child centred play therapy, a non-directive modality which encourages the child to make decisions and take responsibility about what to play with.
The play therapy room may have a sand tray, games like Connect Four or Uno, a white board, baby dolls, stuffed animals, trucks and dinosaurs. During this process the child learns that in this space, it is their special time. The therapist’s role is to return responsibility, encourage autonomy, track the play, reflect feeling and content. Although this does not look like therapy, work is being done; it is building the core foundation that is required for effective therapy.
Why do children take longer to build rapport?
Research describes “stranger anxiety” as the distress that babies experience when they meet or are left in the care of people whom they are unfamiliar with.
Stranger anxiety is a normal part of childhood development and often begins at roughly six to eight months. It is linked with the development of an attachment relationship, and the development of object permanence, and cause and effect.
Often children grow out of stranger anxiety at around the age of two. From this age, it is normal for children to be naturally cautious with adults that they don’t know. Some fear of unfamiliar people is healthy and helpful. On top of natural instincts, due to unfortunate kidnappings and similar, parents, schools and caregivers teach children from a very young age about stranger danger; to not to talk to strangers, to come and tell a trusted adult if a stranger approaches them.
When a child starts to attend counselling, the counsellor is a stranger to them. Taking all the above factors into account, it is then considered a normal response to attachment for your child to feel anxious to be in a room with a stranger, and it takes time for them to feel comfortable and safe. As mentioned above, this process of rapport building often takes 2-4 sessions.
Variables That Influence Rapport Building
Research suggests that building rapport with children and young people can be impacted by a range of factors such as:
- Developmental age;
- Emotional state;
- Emotional maturity;
- The current state the child is in; eg hungry, tired, sad, frustrated.
- The familiarity of the room;
- The communication used by the counsellor;
- Physical environment cultural factors;
- Attachment style;
If you feel that your child could benefit from counselling, please feel free to make an appointment with me.
Author: Larissa Watter, BA Counselling.
Larissa Watter is a Brisbane counsellor, passionate about working with children. She is currently furthering her studies by undertaking a Certificate in Child Centred Play Therapy.
To make an appointment with Larissa Watter try Online Booking. Alternatively, you can call M1 Psychology Loganholme on (07) 3067 9129 or Vision Psychology Wishart on (07) 3088 5422.
- Leach, M. J. (2005). Rapport: A key to treatment success. Complementary therapies in clinical practice, 11(4), 262-265.