Children and Teens

I work with teens and with children from the age of 5.

I am specialized in trauma, stress and nervous system regulation. Sometimes, the cause of this stress or dysregulation is known such as a difficult loss or transition. Other times, therapy is requested in relation to a symptom like trouble sleeping, difficulty concentrating or test anxiety.

I do not administer IQ tests or other formal diagnostic tests.

How is therapy with children different from therapy with adults?

Trauma and psychological stress are different in children.

Children are vulnerable. The weathering of psychological stress moves a person’s resources to coping and away from development. Because kids are in a life stage of unmatched development, this shift in resources is marked in children.

Childhood years are formative. First experiences build our working model for reality and relationships and adverse first experiences and addressing them help a child form a model of the world that is either poled for fight and flight or for trust, connection and growth.

Children have developing nervous systems. Brain areas are still in development and regulation processes are being learned through co-regulation.

A child’s expression of stress can be different.

Children express emotional conflict differently depending on the developmental stage they are in. It is not always easy for them (nor for adults!) to find words to describe tough situations or to label intense or contradictory feelings.

Often, parents and caregivers pick up on a physical symptom with no medical cause like nightmares or tummy aches. Or on a change in behavior like modified sleep patterns, withdrawing from friends, unusual mood swings or a sudden and obsessive interest in themes like death or disaster.

Therapy for children has a different session structure.

And this structure is based on play. Children play through internal conflicts. This play can have one of several psychological functions.

  • It can be a playing out of a conflict scenario or traumatic event. But this time, as the play-er, the child comes to the event from a place of agency that addresses the sense of helplessness felt during the moment of pain.
  • Play works within game rules and physical implements like cards, dolls and figures. In play therapy, these rules and implements can be used by the child as metaphors putting enough distance between the child and a situation that was too intense or too painful. My therapeutic work is to understand these metaphors and to work with them to encourage the child’s internal reconciliation process while sustaining the distance the child has set up in these metaphors to increase their own safety.
  • Play is the space for co-regulation. The younger the child, the more sensitive the developing nervous system. Therapeutic play implicitly contains the offer of attachment and nervous system regulation and stability. This is particularly helpful when the point of the child’s trauma or conflict is also overwhelming for their immediate caregivers.
  • The pleasantness of play nourishes a child’s connected (ventral vagal) state and supports a return for the nervous system out of the stress of fight-flight or freeze.
  • The enjoyment of play brings a child back to their stage of development. It holds their childhood by bringing them back to what a child does. In later stages of therapy, a child will often choose play that returns them to practicing the developmental skill that was interrupted by the traumatic event or difficult stressor.

Therapy for children uses the same methods but…

As with adults, I work with children using Somatic Experiencing and Sandplay Therapy.

Somatic Experiencing and Sandplay Therapy are especially helpful for working with children as the focus on the body, play and imagery works with stress closer to the ways that children regulate it.

While the methods are the same, the way they are actually introduced in a session are different. In adult therapy, it can sometimes be useful to talk directly about the theoretical underpinnings of these methods in nervous system regulation, Jungian psychology and Attachment Theory. The younger the child, the more implicit these foundations are and the overriding tone of the session is the experience of play.

Therapy for children has a different process structure.

The regularity of sessions helps all ages build trust over time but this is especially true for children. Reliability is in itself therapeutic when a sharp change has made the current world feel unpredictable. For this reason, I recommend shorter sessions for children on a regular basis such as weekly.

The process structure of children’s therapy is also different in that it involves parent sessions where I speak to the guardians or parents –- individually or together — without the child.

In these sessions, I share general insights into the child’s regulation and development process in therapy. I also learn from the child’s guardians about the child’s home and school life and this helps me understand the metaphors and symbols they use in play. My main aim in these parent sessions is to help them come to what nearly all parents look for in therapy — a way to more completely understand and support their child.

Stability – when you imagine the natural world and then bring your thoughts to the word „stability“, what animal, plant or natural formation comes to mind?