How I Work

JOHN CROWLEY

Child & Adolescent Psychotherapist

How I work

 

Often parents will feel unsure about asking for help, feeling perhaps they should be able to manage alone or think maybe their worries / concerns are just temporary or growing-up troubles and to be expected. However I also hear many parents say they wish they’d asked for help earlier, if only to put their minds at rest. Some things if left too long can get stuck leaving both children and parents with unhelpful patterns of behaviour and relating that only makes matters worse.

 

I try to tailor support to fit each families' needs, sometimes a one-off consultation with parents is enough, e.g. if a concern can be better understood and managed when recognised as part of ordinary development, like teenage rebellion. However in some cases a short period of work with parents (6 sessions) is needed to help put things back on track, e.g. to better understand and explore new ways to parent controlling behaviour, temper tantrums, food issues, sibling rivalry, etc. Differently sometimes parent / family support alone is not enough and therapy is needed, e.g. when a child’s difficulty affects their learning at school, their capacity to maintain friendships or their ordinary psycho-social development.

 

I have found that in most cases it is best to start by supporting parents and help them develop new understanding & parenting skills as this benefits everyone, especially when there are other siblings at home. Next, and if parent work hasn’t brought about the hoped for changes, I can undertake a short piece of work (3 sessions)

 

to assess the child’s needs and allow the child or young person to have an experience of meeting with me alone - psychotherapy is a big commitment and can feel scary at first. It is not uncommon for this assessment to be enough to bring about a shift in some cases. Following this assessment I will make a recommendation for treatment and together we will agree a way forward - just a few sessions (6) to see if a shift in things is enough or perhaps regular appointments for the whole of a school term.

 

In some cases where the needs are complex, long-standing and / or a CAMHS referral has been made something longer-lasting or more intense may be needed, e.g. sessions for two or more terms of work and/or more than once weekly.

I have a three stage treatment model:

 

  1. I start first with an initial assessment consultation where the child / young person and their parents / carers or Social Workers discuss the identified difficulties and desired outcomes. 

I often recommend parents / carers participate in a period of Parent Work to explore and develop new ways to parent the child / young person. Sometimes seeing the child / young person isn't possible or appropriate (e.g. refusal to participate, ongoing changes in care arrangements, etc) so Parent / carer Work offers an immediate solution when the adults need help and support with a child.

Parent/carer Work is often 6 sessions or until things at home have settled down and/or the adults feel more assured. Such work aims at deepening the parents / carers understanding of each child's moods and behaviour and acquiring new ways to parent 'therapeutically'. It is not uncommon for this to be enough to shift things at home and avoid bringing the child / young person into therapy.

 

  1. When the adults are more able to cope and the child / young person is ready to attend and engage in therapy, the next stage would mean seeing the child / young person for a short period of assessment sessions after which a recommendation for treatment is made.

All treatment plans include therapy reviews with parents / carers and Social Services teams if requested. My NHS training in child & adolescent mental health means I am able to assess whether the child / young person needs specialist or psychiatric input & liaison.

 

  1. The final stage is one-to-one psychotherapy; I see children and young people in short to longer-term treatment plans subject to need and complexity:

 

  • Short term, e.g. 4 to 6 appointments, usually weekly

 

  • Medium term, for one or more school terms, usually weekly at a frequency of weekly

 

  • Longer term (most complexity), e.g. for two or more school terms of work and/or more than once a week sessions.

Membership number #4668