***lizlemon2***

CaptainSerious

You asked about our therapy in the other post.  I figured I'd answer here, because it's complicated.

We are doing talk therapy, mostly.  It's not always ideal, for many reasons (most importantly because I know more about attachment issues (especially in adoption) than our therapist), but I do think that this format works for M.  We were kind of locked into this therapist in the beginning because she is fluent in Spanish and was willing/eager to work with us.  I only found two attachment therapists in the area when we first brought M home, and neither spoke Spanish.  They tried to tell us that we should wait until he gained more English to start therapy because seeing a traditional therapist could do more harm than good, but M needed it right away, and it really did wonders for us during the transition.

While M is turning 10 this week, he's biologically about 12.5.  Emotionally, he's all over the place.  Socially, he's young, but he's lived a hard life, and has seen more than most adults, so he's very experienced in ways, too. He feels responsible for everyone's safety, which is both a gift of compassion and an issue we're working on (because he worries too much about everyone, especially J and his first mother).  My point is that while the boys sometimes play during their sessions, I think M gets much more out of traditional talk therapy sessions, possibly because he's past the play therapy stage.

While he doesn't like to talk about things that are bothering him when we first bring it up, it almost always does two things:  1) gets him to bring up things that are bothering him outside of therapy; and 2) makes him feel better after.  He usually will talk about something for several minutes and then doesn't want to anymore.  So, we learned to take full advantage of the time we can get him to engage, and it's worked really well.  We tackle his life problems, 10 minutes at a time, in and out of therapy.

When I said that our sessions weren't too productive lately, that had more to do with us no longer going every week due to a scheduling conflict.  Since things have been generally good with M right now, the little things that happened during the two weeks between appointments never became a topic for therapy because they usually seemed resolved by the time we got there.  It also didn't help that we now are bringing both boys, and so they were distracting to one another and we only had time to touch surface issues (school, behavior, the weekly schedule). It just started to feel like our sessions were becoming a waste of time, and we wanted to purposely bring the focus back to the boys' deeper needs.

For M, this works.  Sometimes we have to "force" him to think about things and put them in words because otherwise he just internalizes the bad feelings and it turns into bad feelings about himself and poor behavior.  It's not always a pleasant process, but afterward, he always feels better and closer to us.

For J...well, no, this isn't a great set-up yet.  He's young and conditioned to think that if he gets a "talking to" and is asked why he did anything, then he'll be in trouble.  We went through this same thing with M at first, and I was hoping watching M talk to us truthfully about his emotions and not getting into trouble would show him it's okay, but he's a tough cookie.

Again, though, we are sort of stuck with this therapist because of her fluency in Spanish.  And now, despite any other issues/lackings, the boys (at least M) have established a level of trust with her and she knows their entire background.  So we are pushing forward with this set up, and hoping that for J it will all come together as it did with M.  There are times at home when he'll just burst out with something we discussed at therapy, so that's a good sign, and we'll keep trying as we move forward...or sideways, or wherever they are pulling me today!

CaptainSerious

Wow.  That turned out a lot longer than I expected.

lizlemon2

Thank you for the response. I am sorry to pry.  It sounds like you are using who was the best fit, especially where the therapist is bilingual.  If you feel like you are stuck, children or teens often do better when they are doing something active during therapy.  Even if this is just doodling, drawing, playing with a sand or rice table, stress ball, etc.  The eye contact can be intimidating and or uncomfortable, and like you said feel like they are in trouble or being interrogated. I have had 12 and 13 year old wants to do board games, play with dolls, play house, etc.  There is even a therapist in our area who does horseback riding and farm animal care, and the talk just naturally occurs.

 

I am an MSW and have done therapy in the past.  I often help families find the right therapist for them.  That is just why I asked.

 Good luck with everything.  There should be more parents like you who are so sensitive to their children's needs.

CaptainSerious

We let the boys play during the session when we aren't actively involving them (for example, if we are talking with M, we'll let J play quietly in the background).

M will sometimes play while he's supposed to be actively involved, but it's too distracting for him.  He will only talk about the game or other fun things and won't stick to the issue we're trying to discuss.  We are also trying to teach him appropriate eye contact and social mannerisms because they aren't natural to him, so we work hard on having him sit up (as opposed to laying on the floor or couch) and not hiding his face.  Maybe therapy's a place we should let that slide?

For J, if we let him play, he will not talk at all, except about his game.  It's really tough to keep these boys on the conversation, and we thought the toys were just a distraction.  Have you seen kids transition from using them as a way to avoid the conversation to being able to talk and pay at the same time?  How long has that adjustment taken?

lizlemon2

With some kids, I would say the 1st ten minutes or so, we play or color, etc.  It helps build rapport.  Some kids are able to talk and play, even if it is about the play they are doing.  Things like playing house or drawing would lead to a lot of conversations. I could get the conversation back without being forceful.  Sometimes they just weren't ready. I had children who would act out with cars when their dad got arrested.

For M and J,  maybe just something they can do with their hands or look at.  A stress ball, play dough,one of those things people have in offices with the sand and rake (forget the name).  It may take time.  I would think that it would be ok to let the eye contact thing slide a little in therapy.  You are dealing with pretty tough stuff.  Save it for school and social interactions in public, etc.

I really have found with kids of all ages, the not having to look at you thing is big.  They may feel ashamed about what they say.  Most adults say "Look at me when Im talking" when they are in trouble.  I would say most serious disclosures have come in the car while they are in the back seat or doing something like playing basketball. (This is more from my work as a CPS worker).

I don't think there is an answer in terms of time. Some kids are able transition to having more insightful conversations more quickly than others.  Just having an outlet/safe space and knowing it is there can be huge in itself.

CaptainSerious

Okay, I think we are on the right track.  We don't force eye contact in therapy, just ask that M doesn't hide his face (in a pillow, out the window, etc.).  But the reason we are so strict about it is because we are trying to teach him that you show respect with your body language, and rolling around on the floor is not a way to do that.

With M, it's pretty basic stuff.  If things get uncomfortable, he laughs.  Yes, he hides his face when upset or embarrassed, and we are trying to teach him that his apologies will mean so much more to people if he can deliver them while looking at the person and not laughing, for example.  We are very explicit about this with him and really spell it all out.  We use therapy as a way to practice/model the behavior, and it really does seem relevant because he's concerned about leaning how to keep friends (he can make them really easily, but keeping them is a challenge).

I do get your point about not making him look at us when he tells us something he's embarrassed about, and I do see that working for him a lot.  I guess we just tend to read the situation with him.  We're trying to teach him that the way he carries himself and looks at other people is a large part of how they will see if he means what he says.  We talk about this a lot.  I also want him to know that if he is apologizing, it's okay to look me in the eye, because he is taking responsibility and that's something to be proud of.

Pride is another big thing we are battling.  In addition to him thinking feeling that he is somehow responsible for his traumatic past, culturally, Peruvians just aren't a proud people.  There's a strong subculture of shame.  We are always telling him that the key to being a good person is trying your best, and that the things that happened to him that were out of his control are not his fault and in no way mean he is not a good person.  So I want to empower him to be able to look ANYBODY in the eye.

Argh!

As for having something in his hand, maybe we'll try a stress ball, although I'm afraid he may pick at it until it comes apart.  Anytime he has a toy in his hands, his concentration goes right out the window, and it all becomes about that toy and "Are we done yet? I just wanna play!"

lizlemon2

I think you are doing everything you can.  A good strong therapeutic takes time.  Sometimes you have to try things to see what works, and do less of what doesn't work.  I'm rooting for you guys!

CaptainSerious

Thanks, Liz!